Date of Award

2022

Document Type

Dissertation

Degree Name

Ph.D.

Organizational Unit

Graduate School of Social Work

First Advisor

Donny Gerke

Second Advisor

Anthony Fulginiti

Third Advisor

Eugene Walls

Fourth Advisor

Erin Harrop

Keywords

Healthcare, Access to healthcare, Transgender, Non-binary

Abstract

Transgender and nonbinary (TNB) people are more likely to experience negative health outcomes than cisgender (i.e., not TNB) people, but less likely to access healthcare services due to the systemic forces of transphobia and cisgenderism. Despite this, there are few theoretical models of healthcare access specifically designed for TNB people. This three-paper dissertation addresses this gap by developing, refining, and testing the Intersectional Model of Service Use (IMSU), a population-specific framework for researching TNB healthcare access. Manuscript one describes how the initial IMSU was developed from an integrative review of currently available TNB healthcare access literature. This initial IMSU was then revised in manuscript two using qualitative data collected in nine focus group held across the state of Colorado. The revised IMSU was then quantitatively tested in manuscript three using hierarchical logistic regression analyses. Results from manuscript three indicated that the inclusion of TNB-specific healthcare access factors of the IMSU significantly improved its ability to account for healthcare access variance. Specific factors that were significantly associated with healthcare access included self-reporting a disability, sexual orientation, income, the length of time participates needed to wait to access transition-related healthcare, and whether or not participants had changed their gender marker on state-issued identification.

Publication Statement

Copyright is held by the author. User is responsible for all copyright compliance.

Rights Holder

Jarrod Call

Provenance

Received from ProQuest

File Format

application/pdf

Language

en

File Size

210 pgs

Discipline

Social work

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